Sema/B12 (Cyanocobalamin) Injection with Service Fee EMPOWER PHARMACY

You are requesting a service from Dr. K to provide the listed item above to be shipped to the specified address on the order. Because this requires a prescription, you must have received an *Approval Message* from Dr. K to your Push Health account prior to requesting this service. You also must also pay your New Patient Fee if applicable. Do not request this service without prior approval or your request may be refunded minus a 5% processing fee. Returning clients may request a service when ready and do not need permission to request a new service. Please message us with any questions before you request a service and we will happy to assist you.

Not available in CA, MS, WI, and WV.

WI: Empower has temporarily suspended shipping of all products to the state of WI due to licensing delays.

I CAN ALSO NO LONGER PRESCRIBE SEMA TO PATIENTS IN MISSISSIPPI AND WEST VIRGINIA DUE TO STATE MEDICAL BOARD REGULATIONS. THEY WILL NEED TO ORDER TZ HERE.

This product ships to you from Empower Pharmacy. Please allow 10-14 business days for shipping. It ships to any of my patients (except MN temporarily). Please refer to your vial for accurate dosing, as these are multi-dose vials. The medication will need to be refrigerated after arrival, so please place it in the refrigerator when you receive it.

**If you need injection supplies, please add them this to your order. Your order will NOT be sent with injection supplies unless you add them to your cart with this order. Click the following link for the supplies.**

https://topdocstore.company.site/products/Easy-Tou...

DOSING:

*The lower concentration vial is 1mg/0.5mg/ml. This means that there is 1mg of sema and 0.5mg of B12 in each ml of fluid. There are two vial sizes for this concentration, a 1ml and a 2.5ml vial. Therefore, the vials have either 1mg or 2.5mg total sema.

The 1ml vial (1mg total) is used for the 0.25mg dose (25 units/0.25ml), and the 2.5ml vial (2.5mg total) is used for the 0.5mg (50 units/0.5ml) dose.

*The higher concentration vial is 5mg/0.5mg/ml. This means that there is 5mg of sema and 0.5mg of B12 in each ml of fluid. There are also two vial sizes for this concentration, a 1ml and a 2.5ml vial. Therefore, the vials have either 5mg or 12.5mg total sema.The 1ml vial (5mg total) is used for the 1mg (20 units/0.2ml) dose, and the 2.5ml vial (12.5mg total) is used for the 2.4mg (48 units/0.48ml) dose.

*Please note that the same vial used for the 2.4mg dose would deliver 7 weeks of the 1.75mg dose (35 units/0.35ml); however, you would be using two of your doses outside of the 30-day window mentioned above.

STANDARD DOSING SCHEDULE:

Month 1: Inject 0.25mg weekly X 4 weeks

Month 2: Inject 0.5mg weekly X 4 weeks

Month 3: Inject 1mg weekly X 4 weeks

Month 4: Inject 1.75mg weekly X 4 weeks

Month 5+: Inject 2.4mg weekly X 4 weeks

*As long as you stay on a particular dose for at least 4 weeks, you are welcome to move up after that. For instance, patients on the 0.25 mg dose may decide to remain on that dose after they complete the first 4 weeks. Again, as long as you complete at least a 4-week course of each dose, you may move up after that.

**Please note that these packages include 5 weeks of several doses due to the package sizes and formulations. There are no "4-week" packages available for any dose but the 0.25mg starter dose.

***If you are having a lot of side effects with a particular dose, I would recommend not moving up until the side effects lessen.

****Although many people like to stick to the same pharmacy when they reorder, you may order from any pharmacy available for your state. However, please note that the formulations are different across pharmacies, and the units you use for a particular dose may change drastically with a new pharmacy. Please pay careful attention to your vial and refer here for correct dosing.

ORDERING OPTIONS:

In the dropdown box, simply choose one of the dosing options. These will be the instructions printed on your vial.

These packages use the 1mg/0.5mg/ml concentration vials.

1) 0.25mg X 4 weeks (1ml vial).

2) 0.25mg X 8 weeks (1ml vial X 2)

3) 0.25mg X 12 weeks (1ml vial X 3)

4) 0.5mg X 5 weeks (2.5ml vial X 1)

5) 0.5mg X 10 weeks (2.5mg vial X 2)

These packages use the 5mg/0.5mg/ml concentration vials.

6) 1mg X 5 weeks (1ml vial) $350

7) 1mg X 10 weeks (1ml vial X 2)

8) 1.75mg dose: Order the 2.4mg vial. SEE BELOW

8) 2.4mg X 5 weeks (2.5ml vial)* $425

9) 2.4mg X 10 weeks (2.5ml vial X 2)*
*You may ONLY order this package once you have reached the 2.4mg maximum dose and have completed 4 weeks of the 1.75mg dose (plus all lower doses).

**Please note that the same vial used for the 2.4mg dose would deliver 7 weeks of the 1.75mg dose (35 units/0.35ml); however, you would be using two of your doses outside of the 30-day window mentioned above. Please refer to Joint Commission guidelines below

Vitamin B12 (Cyanocobalamin)

Known as the "energy vitamin", vitamin B12 can increase your energy level and help prevent fatigue. Vitamin B12 increases energy, aids in fat and carbohydrate metabolism, and has been shown to suppress your appetite. It also stimulates the utilization of proteins, fats, and carbohydrates in the body.

One of the ways vitamin B12 works in your body is by reducing energy. This energy allows you to be active and not feel fatigued. Energy is very important when it comes to losing weight. Vitamin B12 injections help with this process by increasing your energy, which ramps up your metabolism. A faster metabolism burns more calories This vitamin is also used to help your body get rid of fat more efficiently. It plays an important role in the metabolism of fat through your liver. Some research shows that low levels of vitamin B12 in the body actually contributes to weight gain and obesity. Sufficient levels of the vitamin in your body have been linked to a decreased risk of obesity.

Joint Commission guidelines for proper use of many multi-dose vials include the recommendation to discard the vial 4 weeks after first puncture, even though the Beyond Use Date (BUD) may be longer. These guidelines are generally followed in office and hospital settings, particularly when the vial is used for multiple different patients. However, this same suggestion is made for vials punctured several times a day or only once a week. With certain vial sizes/doses/packages, using all of the medication in the vial without wasting any could result in a patient using the vial for longer than 28 days after first puncture. If you choose to use your vial longer than 28 days after first puncture due to package size or maintenance dosing, you must acknowledge that you understand the Joint Commission recommendations to discard the vial 28 days after first puncture, even if you only puncture the vial once a week. You will be using the vial at your own discretion.

If you have any concerns about this issue and for best safety practices, please choose a 4-week package and discard any medication leftover 28 days after first puncture.